| Titre : | Increase in the Initial Outpatient Rehabilitation Utilization for Patients With Total Knee Arthroplasty (2023) |
| Auteurs : | Mi Jung Lee ; Carole A. Tucker ; Steve R. Fisher ; Md Ibrahim Tahashilder ; Kevin T. Prichard ; Yong-Fang Kuo |
| Type de document : | Article |
| Dans : | Archives of Physical Medicine and Rehabilitation (Vol. 104, n° 11, 2023) |
| Article en page(s) : | p. 1812-1819.e6 |
| Note générale : | https://doi.org/10.1016/j.apmr.2023.03.033 |
| Langues: | Anglais |
| Descripteurs : |
HE Vinci Accessibilité des services de santé ; Medicare ; Réadaptation ; Soins de suite |
| Résumé : | Objectives The objective of this study was to examine the patient characteristics and features associated with the initial rehabilitation utilization with a particular emphasis on outpatient rehabilitation after total knee arthroplasty (TKA) among 2016-2018 Texas Medicare enrollees. Design This is a retrospective cohort study. We used chi-square tests to examine the variability in patient demographic and clinical characteristics across the different post-acute rehabilitation settings after TKA. A Cochran-Armitage trend test was used to investigate the yearly trend of outpatient rehabilitation utilization after TKA. Setting Post-acute rehabilitation settings after TKA. Participants The target population was Medicare beneficiaries aged ?65 with an initial TKA in 2016-2018 and complete demographic and residential information (N=44,313). Interventions Not applicable. Main Outcome Measures We identified whether patients first used (1) outpatient rehabilitation, (2) home health, (3) self-care, (4) inpatient rehabilitation, (5) skilled nursing, or (6) other setting within the 3 months after TKA. Results Our results demonstrated an increasing use of the initial outpatient rehabilitation and home health, while the use of skilled nursing and inpatient rehabilitation facilities decreased from 2016 to 2018. The increase in outpatient utilization was significant in 2018 compared with 2016 controlling for distance to the TKA facilities, comorbid conditions, sex, race/ethnicity groups (White, Black, Hispanic, and Others), lower income (Medicaid eligible), Medicare entitlement types, age groups, and rurality (OR 1.23, 95% CI 1.12-1.34). However, the overall utilization rate of the initial outpatient rehabilitation after TKA remained low, increasing from 7.36% in 2016 to 8.60% in 2018. Conclusion Despite the growing use of the initial outpatient rehabilitation after TKA, the overall rate of outpatient rehabilitation utilization remained low. Our findings raise an important question as to whether certain patient demographics and clinical groups might have limited access to outpatient rehabilitation after TKA. |
| Disponible en ligne : | Oui |
| En ligne : | https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/article/pii/S000399932300240X |
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